3B removal staffing checklist - Texas Department of Family ...



FORMTEXT ? REGION 3B REMOVAL STAFFING CHECKLISTCommunity Based Care Purpose: Use this form to ensure all tasks associated with an emergency or non-emergency removal are completed.Instructions: See the Region 3b CBC Operations Manual for instructions.** This checklist reflects contractual and procedural protocol for emergency and non-emergency removals in Region 3b as per Community Based Care.Case Name: Click here to enter text.Removal Date: Click here to enter a date.Date CompletedDAY 1(within 24 hours)Due Date:Click here to enter a date.Click here to enter a date.Obtain supervisor/PD approval prior to the removal. Discuss with supervisor who will/will not be offered a visit within the first 3 days; for parents who will not be offered a visit, why the visit is not in the child’s best interest.Click here to enter a date.Give the Notice of Emergency Removal and the booklet titled While Your Child is in Care to the parent/caretaker.Click here to enter a plete with parents/caretakers the Child Caregiver Resource Form (2625). FORMTEXT ?? Leave 1 copy with the parents/caretakers. FORMTEXT ?? Ask about American Indian heritage. If a child MAY be of Native American heritage, review and follow policy 2812.4 Person Race and Ethnicity. If a child IS of Native American heritage, review and follow policy 1225 Indian Child Welfare Act, Appendix 1226-A and 1226-B. FORMTEXT ?? Request information on absent parent. Attempt to get absent parents name, address, last address, relative/friends names, last known work place, etc. Attempt to contact absent parents to give a Notice of Removal (form 2231es) and a copy of While Your Child Is In Care. FORMTEXT ?? If the parents/caretakers do not complete the form at the time of removal, ask them to sign the blank form. Encourage parents/caretakers to complete the form and return as soon as possible. FORMTEXT ?? Leave 2 copies of the form with the parents/caretakers (1 for the parent/caretaker & 1 for them to complete and return).Click here to enter a date.If the child is not a US citizen, follow policy 6700 and notify the appropriate consulate using Letter to Foreign Consulates (form 2650). Follow guidelines in Questions and Procedures for Working with Foreign Born Children in Foster Care (form 2013).Click here to enter a date.If a child will be placed with or remain in the home of a kinship caregiver (relative or fictive kin) at the time of removal, initiate the Preliminary Home Assessment (form 6587). The Preliminary Home Assessment must include a criminal history and IMPACT background check, and a visit to the home of the kinship caregiver to assess the home plete placement forms (2085’s) as appropriate.Click here to enter a date.Schedule a visit between the parents and children to occur within 3 days of the Department being named Temporary Managing Conservator.Click here to enter a date.Request from parent: FORMTEXT ?? Child’s Birth Certificate FORMTEXT ?? Social Security Card FORMTEXT ?? Educational Records FORMTEXT ?? Immunization Records FORMTEXT ?? Citizenship/Immigration Status FORMTEXT ?? Medicaid Card FORMTEXT ?? Records/Documents According to Regional ProceduresClick here to enter a date.Obtain as much information about the child’s Medical/Developmental history as possible from the parent/caretaker in order to complete Medical/Dev. History Form in IMPACT.Child Medication(s) Documentation: FORMTEXT ?? Medication Name FORMTEXT ?? Dosage FORMTEXT ?? Frequency FORMTEXT ?? Prescribing Physician FORMTEXT ?? Time of Last Dose FORMTEXT ?? Gather Medications/Medical Supplies (i.e. inhalers, breathing machine, leg braces, wheelchairs) FORMTEXT ?? Gather Assistive Devices (i.e. eyeglasses, dental retainers) FORMTEXT ?? Contact Regional Eligibility Specialist if Pharmacy refuses to refill any medications.Obtain a list of all known: FORMTEXT ?? Schools Child has Attended FORMTEXT ?? Doctors/Clinics Child has been seen at FORMTEXT ?? Location of Child’s Birth (city, hospital).Click here to enter a date.For Kinship Placements ONLY FORMTEXT ?? Complete Placement Summary Form (2279) with as much information on each child as possible. FORMTEXT ?? A copy of Form 2279 is given to each child’s kinship caregiver at placement or within 72 hours of placement. FORMTEXT ?? The caseworker must share all known information about each child’s immediate and special needs at the time of placement. This section must be initialed and dated at the time of placement. FORMTEXT ?? Signatures of the child (if appropriate), the caregiver, and caseworker on the last page signify that all known information about the child was given to the caregiver at placement. FORMTEXT ?? Request daycare for the kinship placement, as needed.Click here to enter a plete conservatorship/removal in IMPACT: FORMTEXT ?? Update INV/FBSS stage prior to completing Conservatorship Removal in IMPACT (see page 3, item #10); FORMTEXT ?? Open Subcare/Family Subcare Stages (see page 4, item #12)Click here to enter a date.If paid foster care placement is needed, contact Our Community Our Kids (OCOK) Intake Unit (intake@#844-777-OCOK) to request a placement for the child. Official request for placement can be made verbally (note the date & time of referral). At a minimum, provide OCOK with the following information about the child: FORMTEXT ?? CPS worker contact information FORMTEXT ?? CPS worker back-up contact information (i.e. supervisor) FORMTEXT ?? OCOK Initial Referral Information (Verbally/Email) FORMTEXT ?? Identify OCOK worker to assign as secondary in IMPACT Additional child's placement info (must be sent via email) FORMTEXT ?? Common Application (form 2087; excluding level of care information), or FORMTEXT ?? Alternative Application for Placement of Children in Residential Care (form 2087ex; excluding level of care) and FORMTEXT ?? Authorization to Furnish Information (form 1505).*Form 2087ex must be reviewed by the CPS Supervisor and then emailed to OCOK (intake@oc- ) within 2 hours of referral; email subject title, “DFPS Emergency Placement-Child Placement Information.”Click here to enter a date.*If the emergency placement is handled by another CPS unit (i.e. night response), then notification of the SSCC placement to the on-going CPS removal worker must occur immediately upon transfer of the case. The on-going CPS worker must notify the SSCC of the CPS worker and supervisor assigned to the case by email.*Within 4 hours of initial contact with OCOK (referral): FORMTEXT ?? Complete conservatorship/removal in IMPACT (see #12 above); FORMTEXT ?? Enter placement referral information in IMPACT;Click here to enter a date.Evaluate and approve OCOK’s recommended placement option and medical consenter within 1 hour of receipt of notification from OCOK in IMPACT (approval can be verbal).*If verbal approval of the placement option and medical consenter is given to OCOK, then: FORMTEXT ?? Approval of the placement option and medical consenter must be documented in IMPACT by 5:00 pm the next calendar day; and FORMTEXT ?? Approved medical consenter form (2085b), education decision-maker form (2085e), and Region 3b Placement Documentation Form must be sent to OCOK by 5:00 pm the next calendar day. The subject line of the email titled “DFPS Emergency Placement-Medical Consenter/Education Decision-Maker.”**Ensure the medical consenter has his or her correct IMPACT PID in order to verify that s/he is the medical consenter when contacting STAR Health and to register for the Health Passport.Click here to enter a date.**Generate Form 2096 from IMPACT within 5 business days to notify court of medical consenter designation.Click here to enter a date.Follow regional procedures to notify: FORMTEXT ?? Family Group Conference staff FORMTEXT ?? Conservatorship staff FORMTEXT ?? Investigation staff FORMTEXT ?? Eligibility staff FORMTEXT ?? Legal FORMTEXT ?? Disability Specialist & Educational Specialist (if needed)Date CompletedDAY AFTER REMOVALDue Date:Click here to enter a date.Click here to enter a date.Contact District Attorney/County Attorney to inform them of removal. Complete legal paperwork as required for each county.Click here to enter a plete Affidavit for removal.Click here to enter a date.File legal documentation as required by each county. (Remember all legal work needs to be filed within 24 hours of the removal or the first working day following a weekend or a court holiday).Click here to enter a date.Participate in Ex-Parte hearing as appropriate for each county.Click here to enter a date.Update the IMPACT Medical Consenter Detail to reflect the court authorization of medical consenter the same day or no later than 7pm on the next day. FORMTEXT ?? If the medical consenter changed after the court hearing, issue new forms 2085b and/or 2085c as appropriate, and generate form 2096 from IMPACT within 5 business days to notify court of medical consenter designation. FORMTEXT ?? If the medical consenter did NOT change after the court hearing, it is not necessary to issue new Forms 2085 B and/or C or notify the court.Click here to enter a date.Obtain copies of all legal paperwork.Click here to enter a date.For paid foster care placement: All child placement information must be sent to OCOK by 5:00 p.m. the next business day. Complete child placement information will be attached to an email titled "DFPS Emergency Placement-Child’s Placement Information." FORMTEXT ?? Email must include date and time of the Initial Coordination Meeting (ICM) FORMTEXT ?? Copy all appropriate CPS staff on ICM date/time notificationChild placement information includes: FORMTEXT ?? Court orders/affidavit FORMTEXT ?? Visitation plans with siblings, parents, or other family member and fictive kin (if established); FORMTEXT ?? Birth verification/certificate; FORMTEXT ?? Social Security card or number (if available); FORMTEXT ?? Education portfolio (started); FORMTEXT ?? Medicaid/Star Health card or qualifying information (if available); FORMTEXT ?? Any external documentation (i.e. assessments, evaluations, or therapy notes) related to the care of the child; FORMTEXT ?? Signed Placement Authorization (2085fc). OCOK will always be the placement; FORMTEXT ?? Signed Medical Consenter (2085b); FORMTEXT ?? Signed Education Decision-Maker (2085e); FORMTEXT ?? Region 3b Placement Documentation Form; and FORMTEXT ?? Authorization to Furnish Information (form 1505).*Any external forms and written placement information not available in IMPACT should be emailed to OCOK (intake@oc-) with subject line, "CPS Emergency Placement."Click here to enter a date.If Child Caregiver Resource form is completed at the time of the removal, initiate the home assessment process (see policy 4520 Placing a Child with an Unverified Kinship Caregiver).Click here to enter a date.Exercise due diligence to identify and notify in writing all adult grandparents and other adult relatives of the child by providing them with Notification to Relatives About a Child's Removal Form (2624).The search for relatives should be ongoing but is required to take place within the first 30 days after the removal of the child. For more details see 2540 Notification to Relatives Following a Removal.Click here to enter a date.Update the following information in INV/FBSS stage prior to completing Conservatorship Removal in IMPACT: FORMTEXT ?? Ensure all parties are listed on Maintain person. This includes all persons in home not previously listed, relative resources, collaterals, etc. FORMTEXT ?? Enter person characteristics for each principal. Make sure no person characteristics apply before marking N/A FORMTEXT ?? Update address/phone number for each person on the Maintain person list. Be sure to add Medicaid address for each child removed from the home. (This should be marked as the primary address for the child. Do NOT “invalidate” the previous removal address for the child.) FORMTEXT ?? Complete person detail for each principal. FORMTEXT ?? Update Person ID’s – social security number, driver’s license, etc. for each principal. FORMTEXT ?? Enter Income and Resource for each principal. FORMTEXT ?? Update education log for each child FORMTEXT ?? Complete criminal history and IMPACT check for each principal, including potential relative placements. FORMTEXT ?? Complete Person Detail CVS/FA home – be sure to add in citizenship and mother’s marital status at time of birth.Click here to enter a plete the Family Tree in IMPACT.See 2537 Establish Relationships in Family Tree in IMPACT When Children Are Removed.Click here to enter a date.Open Subcare/Family Subcare Stages FORMTEXT ?? From Assigned Workload, highlight case and click on the Tasks push button. FORMTEXT ?? From the Tasks list window, highlight Conservatorship/Removal task and click on the Add push button. This will take you back to the Person List. FORMTEXT ?? Highlight the child’s name to be removed. FORMTEXT ?? Click on the Continue button. The Conservatorship/Removal window displays. FORMTEXT ?? Fill in the removal date (actual date of removal) and reason for removal. If person characteristics have not been updated for parent/caretaker, mark those that are appropriate. FORMTEXT ?? On the same window, click on Persons in the Home and click on all persons living in the home at the time of the removal. FORMTEXT ?? Click on the Save button. FORMTEXT ?? For additional children, click on the Add push button. FORMTEXT ?? Follow the above steps for each child.Click here to enter a date.Ensure Placement is in IMPACT in each child’s SUB stage. Ensure that the placement is an actual placement instead of a planned placement. This will be done by OCOK, however, worker is responsible to confirm.Click here to enter a date.Notify the eligibility worker that child has been removed and placed in foster care.Click here to enter a date.Enter Legal Actions in each child’s SUB stage (Be sure to identify the Medical Consenter). See 5240 Documenting Legal Status and Legal Action.Click here to enter a date.Enter Legal Status (be sure to enter as Temporary Managing Conservatorship) in each child’s SUB stage. Make sure the Legal County of removal is correct.Click here to enter a date.Maintain role of the child to “self” and any principal to their appropriate role.Click here to enter a date.Maintain role for each principal in the FSU stage.Click here to enter a rm youth 16 or older of their right to request a court determination of their ability to consent to some or all of their own medical care. Review Notice of Your Right to Request the Court to Consent to Your Own Medical Care (Form 2092) with youth.Date CompletedWITHIN 5 DAYS OF REMOVALDue Date:Click here to enter a date.Click here to enter a plete Foster Care Eligibility for each child (in IMPACT), or provide documentation to Eligibility Specialist, per regional protocol.Click here to enter a date.Ensure placement has scheduled TX Health Steps medical and dental check-ups, and any other appropriate appointments for each child.Click here to enter a date.Start the Education Portfolio and ensure either Our Community Our Kids (OCOK) or kinship caregiver receives it within 5 days of initial placement.See 15381 Creating the Education Portfolio.Click here to enter a date.Ensure the child has been referred to ECI (ECI Screening Referral Form 0789) within 2 business days of the need being identified, if the child is under 3 and suspected of having a disability or developmental delay as a result of exposure to illegal substances, or the disability or developmental delay requires evaluation prior to their scheduled TX Health Steps check-up.Click here to enter a date.*OCOK will issue the ECI referral within 3 days of placement if the child is in paid foster care.Date CompletedWITHIN 10 DAYS OF REMOVALPRIOR TO 14 DAY ADVERSARY HEARINGDue Date:Click here to enter a date.Click here to enter a date.Follow up with the regional FGDM Specialist to identify whether a Family Group Conference or Service Planning Meeting will be held with the family.Click here to enter a plete Page 1 ONLY of ICM/Post-Removal Staffing Form FORMTEXT ?? Attach a copy of the removal affidavit. FORMTEXT ?? Remainder of the form will be completed during the ICM/Post-Removal Staffing.Click here to enter a date.Attend ICM/Post-Removal Staffing and ensure the ICM form is completed at the staffing.Click here to enter a date.Within 24 hours after the ICM (children/youth placed with SSCC), assign CVS worker secondary to the SUB and FSU stages in IMPACT.Click here to enter a date.Develop a temporary visitation schedule with each parent, and complete the Temporary Visitation Schedule Form K-908-2640 with each parent.*Prepare to present the temporary visitation schedule with the court at the Show Cause/Adversary Hearing. See PSA 14-013.Click here to enter a plete the Risk Assessment in IMPACT. This must be completed in order for the CVS unit to initiate the Family Service Plan.Click here to enter a date.If the whereabouts of any parent is unknown, complete the following steps: FORMTEXT ?? Request a Certificate of Service or Non-Service from the U.S. Military’s data center, and attach Form 2068 (6417 Working with Military Families) FORMTEXT ?? Complete Form 2068 (Affidavit Regarding Military Service), and submit it to the Court. FORMTEXT ?? Immediately notify the attorney representing DFPS of any active military status of the parent.Click here to enter a plete court report for Show Cause/Adversary Hearing, if required. Seek information for the court report from PSC as needed.Click here to enter a date.Contact Ad Litem for child to discuss case. Provide copy of court report, if required.Date CompletedWITHIN 14 DAYS OF REMOVALDue Date:Click here to enter a date.Click here to enter a date.If not previously completed: FORMTEXT ?? Designate an appropriate person to be identified as the Education Decision-Maker: FORMTEXT ?? Complete Designation of Education Decision-Maker (form 2085e). FORMTEXT ?? File the most current and correct copy of form 2085e with the court.Ensure a copy of the completed form 2085e is provided to the child’s school, caregiver or facility director, parents, managing conservator, attorney ad-litem, guardian ad-litem, and any other person named by the court to have an interest in the child’s welfare.Click here to enter a date.If not previously completed, complete the Temporary Visitation Schedule with each parent and present to the Court at the Show Cause/Adversary Hearing.Click here to enter a date.Attend Show Cause/Adversary Hearing. Ensure conservatorship caseworker is aware of the court orders from this hearing.Click here to enter a plete the Communication Plan with the Attorney Ad Litem and/or Guardian Ad Litem (form 2071) if one has been appointed. (Obtain input from the conservatorship caseworker regarding communication with the AAL and/or GAL).Click here to enter a date.Update Legal Actions in each child’s SUB stage.Click here to enter a date.If not authorized during the Ex Parte Hearing, update the IMPACT Medical Consenter Detail to reflect the court authorization of medical consenter the same day or no later than 7pm the next day.If the medical consenter changed after the court hearing, issue new forms 2085b and/or 2085c as appropriate and generate form 2096 from IMPACT within 5 business days to notify court of medical consenter designation. If the medical consenter did NOT change after the court hearing, it is not necessary to issue new Forms 2085b and/or 2085c or notify the court.Click here to enter a date.If the education decision-maker changes as a result of the Show Cause/Adversary Hearing, or prior to case transfer, update the Designation of Education Decision-Maker (form 2085e) and distribute to all required parties within 5 days of the change.Click here to enter a plete transfer summary in IMPACT.Click here to enter a plete Request for Diligent Search (form 2277), if there are absent parents with unknown locations. Check the boxes for “Court of Continuing Jurisdiction” and “Paternity Registry” when using this Form. This Form is sent to: FINDRS@dfps.state.tx.usClick here to enter a date.If all parents locations are known: FORMTEXT ?? Submit Bureau of Vital Statistics Form VS 168 “Inquiry on Court of Continuing Jurisdiction for a Child” FORMTEXT ?? Submit this form to the Bureau of Vital Statistics – Texas Department of State Health ServicesClick here to enter a date.If Paternity has not been established: FORMTEXT ?? Submit Bureau of Vital Statistics Form VS 134 “Paternity Registry Inquiry Request” FORMTEXT ?? Submit this form to the Bureau of Vital Statistics – Texas Department of State Health ServicesClick here to enter a anize case file.Click here to enter a date.If the investigation can be completed by the time of case transfer, it should be included in the case file documentation.Click here to enter a date.Plan to attend the Family Group Conference or Service Planning Meeting.CPS Handbook 6138 External Documentation – Substitute care documentation requirements state the following forms must be included in the paper case record. This list is not all-inclusive. Your region or county may have additional requirements for documentation that must be included in the case file. The removal caseworker needs to ensure that any of below that has been obtained, are in the case record, either in IMPACT or the paper file, with copies of certain documents filed in the child’s Education Portfolio. FORMTEXT ?? Birth/citizenship records FORMTEXT ?? Health records, including a copy of a recent medical exam FORMTEXT ?? School records FORMTEXT ?? A copy of the signed foster care assistance application FORMTEXT ?? Copies of signed court orders, affidavits, and other court documents FORMTEXT ?? The court’s determination that CPS made reasonable efforts to prevent removal, reunify the family or seek other permanency goals for a child FORMTEXT ?? CPS notice to caretaker of court hearings, PPMs/administrative review. Caretakers include relatives, foster parents, and pre-consummated adoptive parents FORMTEXT ?? Placement and medical authorizations including medical consenter forms FORMTEXT ?? Designation of education decision-maker FORMTEXT ?? Temporary Visitation Schedule FORMTEXT ?? Correspondence FORMTEXT ?? Other possible documents, such as photographs, authorizations, and letters ................
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